Malaria afflicts 300-500 mn people globally and 2-3 mn die every year. More than a million children die in Africa. The problem is also serious in South East Asia followed by the Indian subcontinent and South America, where economic loss due to morbidity and loss of man-hours is high.
The two major parasite species causing malaria are Plasmodium falciparum and Plasmodium vivax, although P. ovale and P. malariae are also involved, but to a minor extent. While, P. vivax infection is by and large treatable by antimalarial drugs, P. falciparum is proving to be quite difficult to treat effectively. P. falciparum has become resistant to the first line (chloroquine) and second line (sulfadoxine-pyrimethanine (S.P)) drugs and resistance is spreading in different continents (1,2). The roll back programme of the WHO against malaria has received a setback in view of resistance development (3,4) and this has led to a policy decision to use combination therapy with artemisinin or its derivatives as the principal component (5).
Artemisinin is a sesquiterpene endoperoxide isolated from the plant Artemisia annua and the plant extract has been in traditional use in China. Artemisinin, the active principle has been in use for the last 20 years in China (6,7). Artemisinin is very effective and has less side effects. However, outside of China and a few other neighboring countries, it has been used as an emergency drug and there are concerns in introducing it as a front line drug (8). First of all, it is expensive. There is not enough artemisinin available to treat all the cases globally and especially, in Africa although, attempts are underway to cultivate the plant in many countries. Artemisinin monotherapy suffers from the problem of recrudescence. Although, no resistance has so far been reported against artemisinin, wide use as front line drug can lead to improper and suboptimal use leading to development of resistance. Therefore, WHO has favoured the development of drug combinations with artemisinin or its derivatives, so that possible development of resistance to individual components in the combination is delayed and recrudescence due to artemisinin monotherapy is prevented (8).
Reference may be made to Yeung, S, Pongtavornpinyo W, Hastings, I M, Mills, A. J. and White N. J. (2004). Antimalarial drug resistance, artemisinin-based combination therapy and the contribution of modeling to elucidating policy choices. Am. J. Trop. Med. Hyg. 11, (2 suppl.), 179-186, wherein the only registered combination antimalarial with artemisinin recently made available is artemisinin-lumifantrine (co-artem, Novartis International AG, Basel, Switzerland), although efforts are underway to develop other coformulations. Co-artem is expensive, costing around US $2.4 per adult course, compared to the traditional chloroquine/SP therapy costing US $ 0.1-0.2, although efforts are underway to bring down the cost to less than US $ 1.0 (9,10).
Reference may be made to “Reddy R C, Vathsala, P G, Keshamouni V G, Padmanaban, G. and Rangarajan P N (2005) Curcumin for malaria therapy Biochem. Biophys, Res. Comm. 326, 472-474” wherein curcumin isolated from the roots of turmeric (curcumalonga) has antimalarial activity in a culture of P. falciparum and mice infected with P. berghei. Turmeric is used widely in Indian cooking and curcumin is reported to have anti-tumorigenic, anti-oxidant, anti-inflammatory and anti-microbial effects (12,13). However, turmeric has never known to be employed in practice as a drug for treatment of malaria.
Thus, in spite of the increase in incidents of the malarial parasite becoming more and more drug resistant, no prior art known to the applicant discloses an effective alternative to the present day drugs used for treatment of malaria.
Reference may be made to Trager W and Jensen B (1976). Human malaria parasites in continuous culture-Science, 193, 673-675 wherein the P falciparum was maintained in culture using human O+ve red cells and serum by the candle jar method as per standard protocols.